Saline Contrast Echocardiography in Patients With Hepatopulmonary Syndrome Awaiting Liver Transplantation
Background Patients with hepatopulmonary syndrome (HPS) with end-stage liver disease (ESLD) have higher cardiorespiratory mortality than those without. The aims of this study were to determine whether echocardiography could distinguish patients with ESLD with and without HPS and whether the diagnosi...
Gespeichert in:
Veröffentlicht in: | Journal of the American Society of Echocardiography 2009, Vol.22 (1), p.89-94 |
---|---|
Hauptverfasser: | , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 94 |
---|---|
container_issue | 1 |
container_start_page | 89 |
container_title | Journal of the American Society of Echocardiography |
container_volume | 22 |
creator | Lenci, Ilaria, MD Alvior, Ace, BSE Manzia, Tommaso Maria, MD Toti, Luca, MD Neuberger, James, MD Steeds, Richard, MA, MD |
description | Background Patients with hepatopulmonary syndrome (HPS) with end-stage liver disease (ESLD) have higher cardiorespiratory mortality than those without. The aims of this study were to determine whether echocardiography could distinguish patients with ESLD with and without HPS and whether the diagnosis of HPS by contrast echocardiography (CE) was altered by the performance of the test in a supine or standing position. Methods Subjects were recruited prospectively from patients with end-stage liver disease undergoing assessment for liver transplantation. Hepatopulmonary syndrome was diagnosed on the basis of arterial blood gas analysis, lung function testing and agitated saline contrast echocardiography in the absence of primary cardiac or pulmonary disease. Bubble contrast injections were performed supine or standing in a randomised order and read by a blinded observer. Results CE showed late right-to-left shunting in 13 of 50 consecutive patients with cirrhosis (26%). Eight patients (16%) had definite diagnoses of HPS. CE in the standing position consistently increased both the number and the size of shunts compared with supine injection. CE detected intrapulmonary shunting before a change in arterial blood gases. Standard echocardiographic parameters did not distinguish between those with and without HPS. Conclusion This study suggests that screening for HPS in patients with advanced cirrhosis should be done using CE with patients in the upright position. |
doi_str_mv | 10.1016/j.echo.2008.09.020 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66810146</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0894731708005762</els_id><sourcerecordid>66810146</sourcerecordid><originalsourceid>FETCH-LOGICAL-c409t-9d25d89ec3fc89d26f1ef1c4d232e056ef94d892b6c2ed193b3aa8686ebb32f23</originalsourceid><addsrcrecordid>eNp9kVGL1DAUhYMo7rj6B3yQPvnWepO2aQMiLMOuKwwozIqPIU1vdzK2SU3Slfn3psyA4INP4ZJzDvd-h5C3FAoKlH84FqgPrmAAbQGiAAbPyIaCaHLeiPo52UArqrwpaXNFXoVwBIC6BXhJrqgAxjijG2L2ajQWs62z0asQs9sUqZXvjXv0aj6cMmOzbyoatDFkP0w8ZPc4q-jmZZycVf6U7U-2927C7Oa3MtHYx2xnntBnD17ZMI_KxmR39jV5Magx4JvLe02-390-bO_z3dfPX7Y3u1xXIGIuelb3rUBdDrpNAx8oDlRXPSsZQs1xEFX6Zx3XDHsqyq5UquUtx64r2cDKa_L-nDt792vBEOVkgsYxLYJuCZLzNtGreBKys1B7F4LHQc7eTOkiSUGugOVRroDlCliCkAlwMr27pC_dhP1fy4VoEnw8CzDd-GTQy6ATPI298aij7J35f_6nf-w69WO0Gn_iCcPRLd4mepLKwCTI_Vrx2jCkYuuGs_IPHG-jyw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>66810146</pqid></control><display><type>article</type><title>Saline Contrast Echocardiography in Patients With Hepatopulmonary Syndrome Awaiting Liver Transplantation</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Lenci, Ilaria, MD ; Alvior, Ace, BSE ; Manzia, Tommaso Maria, MD ; Toti, Luca, MD ; Neuberger, James, MD ; Steeds, Richard, MA, MD</creator><creatorcontrib>Lenci, Ilaria, MD ; Alvior, Ace, BSE ; Manzia, Tommaso Maria, MD ; Toti, Luca, MD ; Neuberger, James, MD ; Steeds, Richard, MA, MD</creatorcontrib><description>Background Patients with hepatopulmonary syndrome (HPS) with end-stage liver disease (ESLD) have higher cardiorespiratory mortality than those without. The aims of this study were to determine whether echocardiography could distinguish patients with ESLD with and without HPS and whether the diagnosis of HPS by contrast echocardiography (CE) was altered by the performance of the test in a supine or standing position. Methods Subjects were recruited prospectively from patients with end-stage liver disease undergoing assessment for liver transplantation. Hepatopulmonary syndrome was diagnosed on the basis of arterial blood gas analysis, lung function testing and agitated saline contrast echocardiography in the absence of primary cardiac or pulmonary disease. Bubble contrast injections were performed supine or standing in a randomised order and read by a blinded observer. Results CE showed late right-to-left shunting in 13 of 50 consecutive patients with cirrhosis (26%). Eight patients (16%) had definite diagnoses of HPS. CE in the standing position consistently increased both the number and the size of shunts compared with supine injection. CE detected intrapulmonary shunting before a change in arterial blood gases. Standard echocardiographic parameters did not distinguish between those with and without HPS. Conclusion This study suggests that screening for HPS in patients with advanced cirrhosis should be done using CE with patients in the upright position.</description><identifier>ISSN: 0894-7317</identifier><identifier>EISSN: 1097-6795</identifier><identifier>DOI: 10.1016/j.echo.2008.09.020</identifier><identifier>PMID: 19022621</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Cardiovascular ; Contrast echocardiography ; Contrast Media ; Diagnosis, Differential ; Echocardiography - methods ; Female ; Hepatopulmonary syndrome ; Hepatopulmonary Syndrome - diagnostic imaging ; Hepatopulmonary Syndrome - surgery ; Humans ; Liver Cirrhosis - diagnostic imaging ; Liver transplantation ; Liver Transplantation - diagnostic imaging ; Male ; Middle Aged ; Patient Selection ; Preoperative Care ; Prognosis ; Reproducibility of Results ; Sensitivity and Specificity ; Sodium Chloride</subject><ispartof>Journal of the American Society of Echocardiography, 2009, Vol.22 (1), p.89-94</ispartof><rights>American Society of Echocardiography</rights><rights>2009 American Society of Echocardiography</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-9d25d89ec3fc89d26f1ef1c4d232e056ef94d892b6c2ed193b3aa8686ebb32f23</citedby><cites>FETCH-LOGICAL-c409t-9d25d89ec3fc89d26f1ef1c4d232e056ef94d892b6c2ed193b3aa8686ebb32f23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.echo.2008.09.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19022621$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lenci, Ilaria, MD</creatorcontrib><creatorcontrib>Alvior, Ace, BSE</creatorcontrib><creatorcontrib>Manzia, Tommaso Maria, MD</creatorcontrib><creatorcontrib>Toti, Luca, MD</creatorcontrib><creatorcontrib>Neuberger, James, MD</creatorcontrib><creatorcontrib>Steeds, Richard, MA, MD</creatorcontrib><title>Saline Contrast Echocardiography in Patients With Hepatopulmonary Syndrome Awaiting Liver Transplantation</title><title>Journal of the American Society of Echocardiography</title><addtitle>J Am Soc Echocardiogr</addtitle><description>Background Patients with hepatopulmonary syndrome (HPS) with end-stage liver disease (ESLD) have higher cardiorespiratory mortality than those without. The aims of this study were to determine whether echocardiography could distinguish patients with ESLD with and without HPS and whether the diagnosis of HPS by contrast echocardiography (CE) was altered by the performance of the test in a supine or standing position. Methods Subjects were recruited prospectively from patients with end-stage liver disease undergoing assessment for liver transplantation. Hepatopulmonary syndrome was diagnosed on the basis of arterial blood gas analysis, lung function testing and agitated saline contrast echocardiography in the absence of primary cardiac or pulmonary disease. Bubble contrast injections were performed supine or standing in a randomised order and read by a blinded observer. Results CE showed late right-to-left shunting in 13 of 50 consecutive patients with cirrhosis (26%). Eight patients (16%) had definite diagnoses of HPS. CE in the standing position consistently increased both the number and the size of shunts compared with supine injection. CE detected intrapulmonary shunting before a change in arterial blood gases. Standard echocardiographic parameters did not distinguish between those with and without HPS. Conclusion This study suggests that screening for HPS in patients with advanced cirrhosis should be done using CE with patients in the upright position.</description><subject>Cardiovascular</subject><subject>Contrast echocardiography</subject><subject>Contrast Media</subject><subject>Diagnosis, Differential</subject><subject>Echocardiography - methods</subject><subject>Female</subject><subject>Hepatopulmonary syndrome</subject><subject>Hepatopulmonary Syndrome - diagnostic imaging</subject><subject>Hepatopulmonary Syndrome - surgery</subject><subject>Humans</subject><subject>Liver Cirrhosis - diagnostic imaging</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - diagnostic imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Preoperative Care</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Sodium Chloride</subject><issn>0894-7317</issn><issn>1097-6795</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kVGL1DAUhYMo7rj6B3yQPvnWepO2aQMiLMOuKwwozIqPIU1vdzK2SU3Slfn3psyA4INP4ZJzDvd-h5C3FAoKlH84FqgPrmAAbQGiAAbPyIaCaHLeiPo52UArqrwpaXNFXoVwBIC6BXhJrqgAxjijG2L2ajQWs62z0asQs9sUqZXvjXv0aj6cMmOzbyoatDFkP0w8ZPc4q-jmZZycVf6U7U-2927C7Oa3MtHYx2xnntBnD17ZMI_KxmR39jV5Magx4JvLe02-390-bO_z3dfPX7Y3u1xXIGIuelb3rUBdDrpNAx8oDlRXPSsZQs1xEFX6Zx3XDHsqyq5UquUtx64r2cDKa_L-nDt792vBEOVkgsYxLYJuCZLzNtGreBKys1B7F4LHQc7eTOkiSUGugOVRroDlCliCkAlwMr27pC_dhP1fy4VoEnw8CzDd-GTQy6ATPI298aij7J35f_6nf-w69WO0Gn_iCcPRLd4mepLKwCTI_Vrx2jCkYuuGs_IPHG-jyw</recordid><startdate>2009</startdate><enddate>2009</enddate><creator>Lenci, Ilaria, MD</creator><creator>Alvior, Ace, BSE</creator><creator>Manzia, Tommaso Maria, MD</creator><creator>Toti, Luca, MD</creator><creator>Neuberger, James, MD</creator><creator>Steeds, Richard, MA, MD</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2009</creationdate><title>Saline Contrast Echocardiography in Patients With Hepatopulmonary Syndrome Awaiting Liver Transplantation</title><author>Lenci, Ilaria, MD ; Alvior, Ace, BSE ; Manzia, Tommaso Maria, MD ; Toti, Luca, MD ; Neuberger, James, MD ; Steeds, Richard, MA, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-9d25d89ec3fc89d26f1ef1c4d232e056ef94d892b6c2ed193b3aa8686ebb32f23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Cardiovascular</topic><topic>Contrast echocardiography</topic><topic>Contrast Media</topic><topic>Diagnosis, Differential</topic><topic>Echocardiography - methods</topic><topic>Female</topic><topic>Hepatopulmonary syndrome</topic><topic>Hepatopulmonary Syndrome - diagnostic imaging</topic><topic>Hepatopulmonary Syndrome - surgery</topic><topic>Humans</topic><topic>Liver Cirrhosis - diagnostic imaging</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - diagnostic imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Preoperative Care</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Sodium Chloride</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lenci, Ilaria, MD</creatorcontrib><creatorcontrib>Alvior, Ace, BSE</creatorcontrib><creatorcontrib>Manzia, Tommaso Maria, MD</creatorcontrib><creatorcontrib>Toti, Luca, MD</creatorcontrib><creatorcontrib>Neuberger, James, MD</creatorcontrib><creatorcontrib>Steeds, Richard, MA, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lenci, Ilaria, MD</au><au>Alvior, Ace, BSE</au><au>Manzia, Tommaso Maria, MD</au><au>Toti, Luca, MD</au><au>Neuberger, James, MD</au><au>Steeds, Richard, MA, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Saline Contrast Echocardiography in Patients With Hepatopulmonary Syndrome Awaiting Liver Transplantation</atitle><jtitle>Journal of the American Society of Echocardiography</jtitle><addtitle>J Am Soc Echocardiogr</addtitle><date>2009</date><risdate>2009</risdate><volume>22</volume><issue>1</issue><spage>89</spage><epage>94</epage><pages>89-94</pages><issn>0894-7317</issn><eissn>1097-6795</eissn><abstract>Background Patients with hepatopulmonary syndrome (HPS) with end-stage liver disease (ESLD) have higher cardiorespiratory mortality than those without. The aims of this study were to determine whether echocardiography could distinguish patients with ESLD with and without HPS and whether the diagnosis of HPS by contrast echocardiography (CE) was altered by the performance of the test in a supine or standing position. Methods Subjects were recruited prospectively from patients with end-stage liver disease undergoing assessment for liver transplantation. Hepatopulmonary syndrome was diagnosed on the basis of arterial blood gas analysis, lung function testing and agitated saline contrast echocardiography in the absence of primary cardiac or pulmonary disease. Bubble contrast injections were performed supine or standing in a randomised order and read by a blinded observer. Results CE showed late right-to-left shunting in 13 of 50 consecutive patients with cirrhosis (26%). Eight patients (16%) had definite diagnoses of HPS. CE in the standing position consistently increased both the number and the size of shunts compared with supine injection. CE detected intrapulmonary shunting before a change in arterial blood gases. Standard echocardiographic parameters did not distinguish between those with and without HPS. Conclusion This study suggests that screening for HPS in patients with advanced cirrhosis should be done using CE with patients in the upright position.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>19022621</pmid><doi>10.1016/j.echo.2008.09.020</doi><tpages>6</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0894-7317 |
ispartof | Journal of the American Society of Echocardiography, 2009, Vol.22 (1), p.89-94 |
issn | 0894-7317 1097-6795 |
language | eng |
recordid | cdi_proquest_miscellaneous_66810146 |
source | MEDLINE; Access via ScienceDirect (Elsevier) |
subjects | Cardiovascular Contrast echocardiography Contrast Media Diagnosis, Differential Echocardiography - methods Female Hepatopulmonary syndrome Hepatopulmonary Syndrome - diagnostic imaging Hepatopulmonary Syndrome - surgery Humans Liver Cirrhosis - diagnostic imaging Liver transplantation Liver Transplantation - diagnostic imaging Male Middle Aged Patient Selection Preoperative Care Prognosis Reproducibility of Results Sensitivity and Specificity Sodium Chloride |
title | Saline Contrast Echocardiography in Patients With Hepatopulmonary Syndrome Awaiting Liver Transplantation |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T20%3A16%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Saline%20Contrast%20Echocardiography%20in%20Patients%20With%20Hepatopulmonary%20Syndrome%20Awaiting%20Liver%20Transplantation&rft.jtitle=Journal%20of%20the%20American%20Society%20of%20Echocardiography&rft.au=Lenci,%20Ilaria,%20MD&rft.date=2009&rft.volume=22&rft.issue=1&rft.spage=89&rft.epage=94&rft.pages=89-94&rft.issn=0894-7317&rft.eissn=1097-6795&rft_id=info:doi/10.1016/j.echo.2008.09.020&rft_dat=%3Cproquest_cross%3E66810146%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=66810146&rft_id=info:pmid/19022621&rft_els_id=1_s2_0_S0894731708005762&rfr_iscdi=true |